Managing and avoiding hypo-unawareness: A guide for individuals
In the world of diabetes management, maintaining a balanced blood sugar level is crucial. Here's a closer look at hypoglycemia, its symptoms, and ways to manage it effectively.
Hypoglycemia, a condition characterised by low blood sugar levels, can be a concern for those with diabetes. Symptoms such as feeling weak, nauseous, or irritable may indicate hypoglycemia. In severe cases, hypoglycemia can lead to unconsciousness and serious health problems, even death without prompt treatment.
When hypoglycemia becomes severe or when a person loses the ability to perceive early symptoms, an emergency dose of glucagon may be required. Glucagon is a natural hormone that can help quickly raise blood sugar levels. It is typically available as either a nasal spray or an injection. A person who has received glucagon will usually regain consciousness 15 minutes after receiving the dose. If they do not, another dose should be administered.
Maintaining blood sugars within a suitable range for several weeks may help some people get their early warning symptoms back. A common method to safely raise blood sugar levels when they fall below 70 mg/dL is the 15-15 rule, also known as the quick-acting method. It involves consuming 15 grams of fast-acting carbohydrates and rechecking blood sugars 15 minutes later.
Examples of fast-acting carbohydrates include glucose tablets or gel, gummy candies, and regular soda. However, it's important to note that frequent episodes of hypoglycemia can have a negative long-term effect on a person's health, including long-term problems with brain and heart function.
Hypoglycemia unawareness, a condition where a person cannot perceive the early symptoms of low blood sugar levels, can be a serious complication. It occurs when a person's blood sugar levels fall below 70 milligrams per deciliter (mg/dL) or 3.9 millimoles per liter. People particularly at risk of hypoglycemia unawareness include older adults, especially those with kidney disease, and younger individuals with a genetic predisposition. Diabetics, especially those with metabolic syndrome, are also at increased risk.
Causes can include impaired counterregulatory hormone responses and autonomic neuropathy affecting typical hypoglycemia symptoms. Continuous glucose monitors (CGMs) can be beneficial for those at risk of hypoglycemia unawareness as they monitor blood glucose levels and provide alerts if they become too low.
Factors that may contribute to hypoglycemia unawareness include living with type 1 diabetes or type 2 diabetes that requires insulin or other similar medications, having diabetes for more than 10 years, often having low blood sugars or trying too hard to reach low levels, having difficulty managing diabetes, living with other conditions that can limit the ability to manage blood sugars, such as dementia, and taking certain medications like beta-blockers for high blood pressure.
Circumstances that may increase a person's risk of hypoglycemia include an excess of diabetes medications, a lack of carbohydrates in the diet, timing of diabetes medications, amount and timing of exercise, alcohol consumption, hot weather, menstruation, time at high altitudes, puberty, and changes to regular schedules.
Severe hypoglycemia, also known as level 3 hypoglycemia, is when a person is unable to function and requires assistance from another person to recover. Severe hypoglycemia can lead to brain or organ damage or even death without prompt treatment.
In conclusion, managing hypoglycemia is crucial for maintaining good health in those with diabetes. Recognising symptoms, understanding the 15-15 rule, and being aware of factors that increase the risk of hypoglycemia can help manage this condition effectively. For those at risk of hypoglycemia unawareness, continuous glucose monitors can provide valuable alerts and help manage blood sugar levels more effectively.
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